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Home My WebLink AboutBLDE-22-003187 Commonwealth of Official Use Only 'firin• 1( � Massachusetts Permit No. BLDE-22-003187 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:12/6/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work descrielow. Location(Street&Number) 48 SEAVIEW AVE '—"r144I5 Owner or Tenant Telephone No. Owner's Address 84 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Miscellaneous work per attached. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 at4.k (24 I (2-i vi/ 9/7iw c 7/2 ( 7 et I• - i DEC 03 2021 't 1 / Co lino sa[AA��h o`�YJaeeachuestle Official Use Onlyy �, !I Permit No. e.---'212-":3 V 1 tt , ' Ai«�, L10p1.&ivies,' ,Ia 3 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) t APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 i (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1�l0 3/Z City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical Fork described below. Location(Street&N jn/her) 7g S �-ut eU Ave_ c z ..' `, m4- Owner or Tenant /f��arn Telephone No. 5'0 81711).83..? vl Owner's Address /1 L424.t.6/i dpeofith �e4ets M40/der5*--- Is this permit in conjunction with a building permit? Yes 2 No ❑ (Check Appropriate Box) ......' Purpose of Building ii s ems(/iV(' Utility Authorization No. Existing Service id p Amps 120 /L YO Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location andNatureof ProposedElectrical Work: ` u` tied -J ,y,' ier/ 3[..7 5-,I 4, /4.4.4.,,., _ ✓!—..i i,as 4..,•;�`,/ ip �K.i��1(1,.,1'1.c."(n�Ly,- Q vl .,;vCompletion of the followinVable maybe waived by the Inspector of Wires. U No.of Recessed Luminaires No.of Ceil:Sasp.(Paddle)Fans No.os Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA CA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting irnd. grnd. ❑ Battery Units _ :;:' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones w No.of Switches No.of Gas Burners -No.of Detection and v. Initiating Devices 1 No.of Ranges No.of Air Cond. TotaloNo.of Alerting Devices No.of Waste DisposersHeat Pump Number Tons KW 'No.of Self-Contained Totals: . """'-"' ' Detection/AlertingDevices No.of Dishwashers S ace/Area HeatingMunicipal P KW Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electric 1 Work: 5 c.&o (When required by municipal policy.) Work to Start: 1112 S72/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.. Address: Alt.Tel.No.: "Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)[owner ❑owner's agent. Owner/Agen4 Signature ��1. Telephone No. 96 575 2853 PERMIT FEE:$